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NPI Code Detail

MEDICARE: SUSAN P PHILLIPS MT-BC

MEDICARE:   SUSAN P PHILLIPS  MT-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225A00000XMusic Therapist

General Provider Information

NPI Number : 1063598969
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN P PHILLIPS MT-BC
Provider Business Mailing Address
First Line : 634 RICHFIELD DR
Second Line :
City : WINDCREST
State : TX
Zip : 78239-2010
Country : US
Telephone Number : 210-324-1430
Fax Number :
Provider Business Practice Location Address
First Line : 634 RICHFIELD DR
Second Line :
City : WINDCREST
State : TX
Zip : 78239-2010
Country : US
Telephone Number : 210-324-1430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 01/11/2014

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Directions to “ SUSAN P PHILLIPS MT-BC” Practice Location

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